Comparison between diagnosis and treatment of community-acquired pneumonia in children in various medical centres across Europe with the United States, United Kingdom and the World Health Organization guidelines

Table 2 Comparison of inpatient diagnostic test indications for community-acquired pneumonia (CAP) across different European medical centres compared with United States [13] and United Kingdom [1] guidelines

Diagnostic test	Guideline		European study
Diagnostic test	PIDS-IDSA	BTS	European study
Chest radiograph	Yes	Yes	Yes
Complete blood count	Yes^a	No	Yes
Acute phase reactants (CRP, serum PCT, ESR)	Yes^a,b	No	Yes
Sputum samples for bacteria	Yes	Not specified	Yes^c
Tests for Mycoplasma, Chlamydia ^d	Yes	Yes	Yes^c
Tests for respiratory viruses^d	Yes	Yes	Yes^c
Blood culture	Yes	Yes	Yes
Nasopharyngeal secretions	Not specified	Yes	Yes^c
Serum electrolytes	Not specified	Not specified	Yes
Not recommended	Urinary antigen detection for pneumococcus Diagnostic testing for Chlamydophila pneumoniae	Urinary Antigen detection for pneumococcus Acute phase reactants
Other	Tracheal aspirates for gram stain and culture	Pleural fluid for microscopy, culture and antigen detection

With the exception of a chest radiograph, the World Health Organization does not mention use of specific inpatient diagnostic testing and is excluded from the table
PIDS-IDSA Pediatric Infectious Diseases Society and the Infectious Diseases Society of America, BTS British Thoracic Society, ESR erythrocyte sedimentation rate, CRP C-reactive protein, PCT procalcitonin
^aDiagnostic test recommended only for those with severe disease
^bAcute phase reactants cannot be used as the sole determinant to distinguish between viral and bacterial causes of CAP
^cTests recommended in <50 % of medical centres
^dSerology, polymerase chain reaction, culturing and other tests are available but no specific test is recommended

ISSN: 2200-6133